Many articles about diabetes appear daily, many of them very interesting. The intent here is to make some of these available for others who may not see them or have bypassed them. I will try to comment briefly on those I have grouped or on an individual article. This is not guaranteed to be a daily post, but I hope that this will give you ideas for your own research or blog posts. Please talk to your doctor about medical problems.

05 September 2013

PCPs Are Putting Themselves In a Bad Light

Primary care physicians are taking it on the chin, but in many
cases are doing this to themselves. I think doctor bashing is too
polite for the things I am reading about what the PCPs are doing.
Dr. Michael Cetta cites even more cases where PCPs are damaging their
profession. In some areas of the US the shortage is already being
felt and people are reacting negatively to what they are doing.

I am even hearing about court actions against some PCPs for not
doing what they are not letting others do. Yes, this is getting very
upsetting in some areas. These doctors have smashed the pedestal
they had placed themselves on, and people are hauling away the
pieces. When primary care isn't available like the example covered
in this blog, tempers become very short. I have heard from the
fellow in this blog again and the doctors are dumping all patients
working for the company because they could not wait for about six
months for an insurance required physical. If the company was
requiring the physical, then they should have waited, but the
insurance company would give no extra time. The fellow said this is
getting very nasty in the community. Two doctors that had insurance
are without insurance because a division of the insurance company
that required the physicals, canceled their insurance.

Since this is a company town, this meant that 90% of their
patients were gone and the remaining patients said no thank you and
are looking elsewhere for a doctor. Then the owner of the building
containing the offices of the two doctors served them with an
eviction notice because he said they would not be able to pay the
rent. One has already moved into another office about an hour away
and the second will be joining him. What surprises this person is
that the doctors are trying to prevent other doctors from moving into
the town they were evicted from.

In some larger communities, Transition Care programs are beginning
to take up the slack for PCPs to care for patients fresh out of
hospitals. Because of the emphasis by the Centers for Medicare and
Medicaid Services (CMS) of penalizing hospitals for too many
readmissions, Transition Care programs are sending healthcare
providers into the patient's homes. This is stirring up opposition
from PCPs who don't want another care provider stepping in, or the
PCPs don't understand the value. After all, (tongue-in-cheek) aren't
PCPs supposed to have a proprietary right to oversee their patients'
health.

The telling fact is disturbing because everyone does not have a
PCP and about 50 percent of the Medicare readmission patients will
not have been seen by a primary care physician between admissions.
Of the $17 billion spent each year on only Medicare patients, 75
percent of those readmissions are considered preventable. Why aren't
the PCPs taking care of them? Because they do not have office time
to fit them in and some patients do not have access to a PCP.

Dr. Cetta has this example, “To solve this enormous problem,
Transition Care programs need to work closely with PCPs. But right
now, a large number of patients who could benefit most from
Transition Care are weeded out of the programs because of PCP
opposition. In one recent pilot program at a hospital in Maryland,
roughly a third of all patients who otherwise qualified for
Transition Care were weeded out because of their primary care
doctor’s opposition.”

Turf wars are not pleasant for the patients and it is time to have
patients take up the cry to PCPs saying if you don't have time to see
me, then step aside, you will no longer be my doctor. Even
caregivers are considering this, as they don't wish to see their
people reenter the hospital so soon after discharge.

About Me

I am enjoying life, despite diabetes type 2. I am retired and enjoying the time I have for writing and photography. I was diagnosed with type 2 on Oct 2003, on oral meds for 4 months and they were doing nothing to really improve my daily readings. By cutting my carbohydrates I received the most improvement, but still not enough. Then I requested insulin, even though I did not like the thought of needles. That brought about the biggest change and A1c's in the lower 6's and upper 5's. Now I am working at maintaining them under 6.0 and hopefully nearer 5.5.